A recent Scottish study of a hundred people with diabetes found that about 63 percent of them were wearing the wrong shoe size. Because feet become wider and longer when they are being stood upon, all the patients had their feet examined while they were both sitting and standing.

Under those circumstances, only 37 percent were wearing footwear of the right size. Forty-five percent of the shoes were the wrong width, most often too narrow. Some people had settled for the wrong shoe width in order to get the right shoe length, and some may have bought a smaller shoe for the sake of vanity.

The right shoe size is important because ill-fitting shoes can cause foot ulcers that eventually lead to amputation. The World Health Organization has said that 80 percent of foot amputations could be prevented, in part by wearing well-fitted shoes.

Unfortunately, 15 percent of people with diabetes develop a foot ulcer sometime in their lives. In this experimental group, 45 percent had experienced previous foot problems already, including ulcers, calluses, bunions, corns and swelling. Seven percent had foot ulcers, and 20 percent had sensory nerve problems in their feet. Nevertheless, 22 percent never checked their feet, and only 29 percent checked them daily.

Unfortunately, shoe sizes vary from one manufacturer to another, making it difficult to know your size if you buy from different shoemakers. If you are in the market for a new pair of shoes, find a store that uses those metal foot-measuring devices that you might remember from shoe shopping as a child. In addition, purchase a pair that offers a choice of widths in each size.

What to Look for When Buying

According to the International Journal of Clinical Practice, the following factors should be considered when buying shoes:

"Ulcers can form because of tight-fitting shoes causing constant pressure. However, loose shoes also cause ulcers as a result of friction. When footwear is fitted properly, it can reduce high-pressure areas and hence reduce callus formation and the threat of ulcer formation. It will also fulfill its function as a barrier to the environment. Ill-fitting footwear can disrupt the biomechanics of the foot and ankle and can give rise to problems, including pain. Footwear should be designed to relieve pressure areas and reduce shock and shear forces, and it should be able to accommodate deformities by supporting and stabilizing them."

"It is necessary that shoes fit for both size and shape. The shoe must be wide enough to accommodate the first metatarsophalangeal joint. Shoes should be fitted whilst weight bearing. The location of the widest part of the shoe should be checked, allowing extra room at the toe box. Adequate room should be left across the ball of the foot, and a snug fit should be made around the heel. It is also important to realize that many people have mismatched foot sizes."

Source: EurekAlert; International Journal of Clinical Practice, November 2007